Post: Early Intervention Services, Central and West Lancashire Spoke Team.
Name of Supervisor: Dr Alison Summers
Location of the post: Euxton Lodge, 16 Euxton Lane, Chorley PR7 1PS.
Telephone numbers: 01772 64 5765 (Ruth Bain, Medical secretary)

1. DETAILS OF PLACEMENT (LOCATION, POPULATION, INPATIENT OR OUTPATIENT, BEDS)
The placement is with community based multidisciplinary Early Intervention team. The team covers a large catchment area including Preston, Chorley, Leyland, Skelmersdale, Ormskirk and Aughton. The majority of assessment are domiciliary visits.

The on-call commitments are for general adult and old age psychiatry at the sites of Preston, Chorley and Ormskirk.

Core Placement: Yes
Endorsements: No
Supervisor: Full time

2. DETAILS OF ROLE AND RESPONSIBILITIES AND EXPERIENCE TRAINEE WILL GAIN

With appropriate supervision and support:

Assessment of individuals with possible early psychosis referred to the EIS, including individuals posing difficult diagnostic challenges.

Providing medical input into multidisciplinary management of EI clients with psychosis or with ‘at risk mental state’ (i.e. deemed to be possibly in prodromal stage of psychosis).

Contribution to psychosocial approaches to work with people with psychosis

Where appropriate to trainee’s learning needs, opportunities for

Gaining experience in using structured assessments for psychosis and possible psychosis prodrome.

Contributing to specialist interventions eg. for substance misuse, treatment resistance
Contributing to service development

Development of skills in psychosocial approaches

Participation in research within the service.
Core clinical work
Clinical work takes place primarily in clients’ homes, or in community settings arranged to suit clients’ needs, though when EI clients are admitted to hospital the trainee will also need to liaise with inpatient team as appropriate.

Clinical work is primarily with clients aged 16-35 and includes

• Assessments of referred clients to determine suitability of the service, including opportunity to participate in the service’s specialised assessment clinic and gain experience in use of standardised instruments including PANSS (Positive and Negative Syndrome Scale), CAARMS (Comprehenisve Assessment of At Risk Mental States), SPI-A (Schizophrenia Proneness Inventory).

• Participation in direct and indirect clinical work with EI clients and their families, as part of the multidisciplinary team, including comprehensive assessment, prescribing and medical contributions to management. This includes opportunity to take the lead medical role for a subset of the team’s clients. Trainees will be expected to be aware of basic psychosocial approaches used in the team, for example motivational interviewing, goal setting etc. and use these where appropriate. (These approaches are cognitive behavioural principles and described in a handbook developed by the service’s psychological therapy team). Trainees will be expected to participate in team clinical meetings relevant to their clients, including daily clinical meetings, and meetings focused on psychosocial intervention. Trainees will also be expected to liaise with other services as appropriate including CAMHS, forensic services, learning disability services.

The team also provides a service to clients aged 14 and 15, under the supervision of a CAMHS consultant, and trainees contribute to this in accordance with their training and experience.

3. JUNIOR DOCTOR SUPPORT AND SUPERVISION
There are usually no junior doctors in the post but opportunities are available to support and supervise trainees in Preston and Chorley e.g. doing WPBAs, journal clubs and case discussions.

4. ON CALL COMMITMENT AND PAY BANDING
On call is 1 in 9, covering general adult and old age psychiatry for the Central and West Lancashire areas (main towns Preston, Chorley, Leyland, Ormskirk, Skelmersdale)

The trainee is second on call, providing advice and support to the first on call doctor, as well as MHA work.

Supervision
• immediate supervision available through an on-call consultant.
• trainees are also encouraged to discuss issues arising while on call with the educational supervisor
Banding: 1B

5. TEACHING / SUPERVISION / ACADEMIC EXPERIENCE
• Journal club and case presentations Wednesdays 2-4 pm as part of Preston psychiatry academic programme
• EI service CPD meeting 1 hour / month
• EI service in house training programme also available – rolling programme of topics, including training in PANSS, psychosocial interventions, etc
Facilities
• The Central team of the EI service is based in community premises, accommodating case managers, psychiatrists and admin staff.
• The trainee has their own desk and filing cabinet in a shared office. Laptop and Blackberry are provided.
• The trainee shares support from a medical secretary with the consultant and staff grade doctor.
Supervision arrangement
• Weekly 1 hour educational supervision
• Additional clinical supervision as needed – arrangements to suit trainee’s needs.
Teaching and academic experience
Opportunities for contributing
• Within the EI service – participating in training within the multidisciplinary team, or wider service, also for supporting the staff grade doctor, and variable opportunities for teaching medical students.
Outside the service – opportunities for contributing to the Preston academic programme contributing to teaching of CT 1-3 trainees, and teaching medical students.

6. AUDIT / RESEARCH OPPORTUNITIES
Audit and research are a high priority in the EI service, and there are a variety of research and audit projects in progress, and several members of staff in the wider service with university appointments and extensive research experience. There are opportunities for an ST4-6 trainee to contribute to already established projects, or to be supported in developing work of their own.

7. MANAGEMENT EXPERIENCE
Extensive opportunities within EI service – eg. for participation in operational management, contributing to ongoing service development, leading initiatives or managing projects.

A variety of additional opportunities available within the Trust.

The supervising consultant has extensive experience of management and of working as a consultant in public health medicine.

8. ADDITIONAL EXPERIENCE AVAILABLE
The supervising consultant has a special interest in the role of psychodynamic approaches in psychosis and a range of opportunities are available for a trainee interested in developing an interest in this field.

Special Interest opportunities

Trainees interested in a special interest session in the service are very welcome, and a clinical, management or audit / research focus can be developed according to needs and interest.

9. IMPORTANT ADDITIONAL DETAILS (FACILITIES etc)

A small free car park is available on site and a large paid parking at Chorley District General Hospital is also available.

PROBABLE TAMETABLE (EXAMPLE OF COMMITMENTS)